Overview of the role of rehabilitation for arthritis

Physical rehabilitation offers a number of techniques that can help decrease pain and improve mobility in dogs with arthritis. It can broadly be divided into three categories:

  • Manual therapy
  • Therapeutic modalities
  • Therapeutic exercise

Manual Therapy

Manual therapy is what human physical therapists do to relieve pain and improve joint motion for their patients. Veterinary rehabilitation therapists can also use joint mobilization, soft tissue mobilization/ massage, passive range of motion (PROM), and stretching to treat dogs with arthritis.

Animals with arthritis often develop compensatory dysfunctions in surrounding soft tissues and distant joints. Rehabilitation therapists (veterinarians or physical therapists trained in canine rehab) will want to assess your dog’s whole body to identify where they might have compensatory pain, trigger points, or reduced mobility.

Your rehabilitation therapist will want to apply manual therapy techniques to the arthritic joints as well as other areas of the body, where needed.

Therapeutic Modalities

A therapeutic modality means applying something physical to your dog’s body, often to help relieve pain.  Veterinary rehabilitation therapists will often use:

  • Cryotherapy (ice packs)
  • Thermotherapy (heat packs)
  • Lasers
  • Pulsed electromagnetic field (PEMF)
  • Neuromuscular electrical stimulation/ transcutaneous electrical nerve stimulation (TENS)
  • Extracorporeal shockwave therapy (ESWT).

Ice packs/ cryotherapy:

Ice is recommended to decrease inflammation following an acute injury or “flare up.”  Ice will decrease blood flow to the area and numb the joint to reduce pain.

Your dog might feel better after exercising if you ice their sore joint with an ice pack. The ice pack should ideally be held in place for 15-20 minutes. NEVER place an ice pack directly on the skin. Instead, make sure you wrap it in a damp towel or pillowcase. Using an Ace bandage for moderate compression can also help.

Never leave your dog unattended with an ice pack. While cold compression or ice packs have not been specifically studied for dogs with arthritis, it is a practical and cost-effective means of reducing inflammation and pain and can be done at home.

Heat packs:

Heat is recommended to reduce muscle spasms and provide a soothing sensation.  Applying heat increases blood flow to an area, even if only slightly below the surface. If your dog has sore joints, ask your veterinarian about applying a warm pack to their low back or muscles surrounding the affected joint.

NOTE: **Heat should be applied at least 2 hours after exercise and should not be used in the acute stage of injury.

Therapeutic LASER/ photobiomodulation:

With laser therapy, light energy (photons) is applied to stimulate tissue. Therapeutic lasers stimulate cellular metabolism, fibroblast proliferation, collagen deposition and enhance angiogenesis, but they are not capable of cutting tissue.

Additionally, they can provide pain relief through increased secretion of serotonin, increased release of endogenous opiates, decreased inflammation and blockage of afferent C fiber depolarization. Several lasers are currently marketed for veterinary use and differ based on their wavelength and power, which influence the depth of penetration and time required for treatment, respectively, and their ability to cause injury to the eye and skin.

Talk to your veterinarian if laser therapy might help your dog.


All cells and tissues in the body have their own electromagnetic field. When cells are diseased or damaged, the electrical gradient across the cell membrane is disrupted, and the electromagnetic field in the body is altered.

Applying PEMF generators have been shown to increase certain molecules (such as Nitric Oxide) that help restore the normal electromagnetic field in the body. PEMF therapy is used to decrease pain and inflammation and stimulate tissue healing.

There are studies in human and veterinary patients documenting these effects, though the optimal protocol for use for dogs with arthritis is not yet known. PEMF is applied through a bed that your dog can lay on, such as the Respond PEMF bed, or through disposable devices that are placed or held over the treatment area, such as the Assisi Loop. They can both be purchased for home use.


A continuous, low-level electrical current is applied to the body to stimulate a type of nerve ending that transmits sensations to the spinal cord faster than the dull ache associated with chronic pain.

That means that the spinal cord and brain recognize the “tingly” sensation of TENS rather than pain from arthritis. Talk to your veterinarian or rehabilitation therapist about TENS for your dog.


This uses high-powered focused ultrasound. Sound waves are transmitted to the tissue, which stimulates cells to express growth factors and other molecules that improve healing and decrease pain. One study found that dogs with unilateral hip arthritis who had ESWT treatment developed a more symmetrical gait after use.

Another study found that ESWT for elbow arthritis resulted in improved peak vertical force, similar to what is expected with NSAIDs. Of all of the modalities used in veterinary rehabilitation, ESWT currently has the most research in clinical veterinary patients.

Therapeutic Exercise

In addition to regular aerobic exercises such as walking or swimming, talk to your veterinarian or rehabilitation therapist about incorporating therapeutic exercises into your home routine to help increase or maintain your dog’s strength, flexibility, and proprioception. This helps your dog maintain their functional mobility.


Water offers several beneficial properties that make hydrotherapy and the underwater treadmill (UWTM) useful in veterinary rehabilitation. Depending on the height of the water, the buoyancy of the water will provide varying levels of support for dogs that are weak or in pain.

The cohesion and turbulence of the water provide a resistant force when walking through the water. This helps increase the range of motion of their joints. Additionally, it is more challenging to walk through water, leading to increased muscle strength and endurance following regular therapy in an underwater treadmill.

Finally, the water temperature in most underwater treadmills or pools is kept around 85 degrees F, which helps increase blood flow to the limbs and provides a soothing environment. Studies have found that dogs enrolled in a UWTM-based rehabilitation program have improved weight loss and maintenance of muscle mass—both of which are crucially important to help manage arthritis!

Want to find a rehab professional near you? Visit www.rehabvets.org



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